CMS Formulary

Displaying 121231-121240 of 1611142 results.
ID: 121231
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121232
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121233
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121234
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121235
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121236
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121237
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121238
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121239
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121240
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0